Keppra and Low Motivation

[chris-s11]

So I was diagnosed when I was 14 and put on Lamictal. It worked fine until I was 17. Now, during my first 3 years in high school I excelled. I took as many honors classes as I could as well as a few AP classes. I always took it seriously, even if I did have a slight procrastination problem.

The summer before my senior year I had some breakthrough seizures and my Lamictal was supplemented with Keppra. Since then, I've been seizure free, so it obviously works.

Now on my final semester of university I look back on the previous four years with regret and the failure to connect the dots. My senior year in high school was my first year where I stopped taking my schoolwork seriously. Granted I already had a great GPA, honors classes, and college credit under my belt already, I still could have tried harder. Instead I took easy classes, and only 1 or 2 honors.

Then came along university. Throughout my undergrad courses, I still managed mostly Bs with a few As, however I just wasn't taking my work seriously. I heavily procrastinated, skipped classes, forgot about homework, didn't bother to join any organizations, do volunteer work, get a job, nothing. I preferred to just sit around and had absolutely no motivation. I also had little interest in ANY subject and thus found it hard to pay attention. I briefly flirted with the idea of ADHD my sophomore year, but dismissed it. During my annual neurologist appointment I requested to be taken off Lamictal and go with only Keppra as I knew Lamictal had some issues with concentration.

With just Keppra, nothing really changed. I then realized it all started my senior year in high school, the first year I was on Keppra. Could Keppra be a factor behind my underachievement in college? I realize there could be other factors too, such as an inherent problem in my personality or the fact that I was no longer facing as much possible scrutiny from my parents, but it's interesting how it started after I began Keppra.

 

[arnie]

Welcome! Sorry to hear about the issues you're having. Finding the right med, or combination of meds, can be a real challenge. I was on Dilantin for about 15 years, then switched to Lamictal when the Dilantin started affecting my gums and possibly my hippocampus. The Lamictal worked as well as the Dilantin had. though throughout the past 30 years on sz meds I have always had several hundred partial szs a year. A few years ago my neuro suggested a trial of Keppra and then of Zonegran. After only a few weeks on each of those I felt absolutley horrible. Depressed and hopeless. Just awful. I'm back on the Lamictal and supplementing it with Trileptal which now seems to work OK. I've had fewer szs than normal and if I keep the trileptal dose low enough I minimize the side-effects (mostly gastrointestinal difficulties.) Too much Lamictal can make me listless, tired, unmotivated. As I said, I find it to be a real balancing act, and I have come to the conclusion that I will have to accept some seizures in order to have a good quality of life. I want to stress that during this whole time I have been very active in all sorts of activities, have gotten a couple of college degrees, have had 2 satisfying careers (I'm in the second one now), have raised 3 great kids and have the same wife I did 33 years ago, so the partial szs have not held me back at all. I strongly encourage you to pay attetion to how you're feeling, keep a journal about it and about what meds you are on (and the dosages), and don't accept a poor quality of life! You are waaaay too young for that! Keep us posted.

 

[Nakamova]

I had a similar curve -- excelled through most of high school, then slacked off at the end and in college -- and that was long before I ever had seizures. Late adolescence is a time when we are undergoing quite a few transitions, emotionally and physically/metabolically...

That said, both seizures and meds can potentially take a toll, and affect attention, mood, and energy. It's possible that Keppra had that effect on you -- there's no real way to know for sure. The main thing to focus on is how you're feeling now. If you're feeling "blah" on the Keppra, there are other meds to try, and you should discuss options with your neurologist. You may also want to look into neurofeedback. It can help with attention issues as well as with seizure control. Some perfectly healthy people use it to improve concentration and mood. The drawbacks are that it isn't often covered by insurance, and requires a commitment of not only money, but time (up to 40 sessions). It can also be tough to find a practitioner. More info about nfb here: http://www.coping-with-epilepsy.com/forums/f22/eeg-neurofeedback-501/

 

[chris-s11]

Welcome! Sorry to hear about the issues you're having. Finding the right med, or combination of meds, can be a real challenge. I was on Dilantin for about 15 years, then switched to Lamictal when the Dilantin started affecting my gums and possibly my hippocampus. The Lamictal worked as well as the Dilantin had. though throughout the past 30 years on sz meds I have always had several hundred partial szs a year. A few years ago my neuro suggested a trial of Keppra and then of Zonegran. After only a few weeks on each of those I felt absolutley horrible. Depressed and hopeless. Just awful. I'm back on the Lamictal and supplementing it with Trileptal which now seems to work OK. I've had fewer szs than normal and if I keep the trileptal dose low enough I minimize the side-effects (mostly gastrointestinal difficulties.) Too much Lamictal can make me listless, tired, unmotivated. As I said, I find it to be a real balancing act, and I have come to the conclusion that I will have to accept some seizures in order to have a good quality of life. I want to stress that during this whole time I have been very active in all sorts of activities, have gotten a couple of college degrees, have had 2 satisfying careers (I'm in the second one now), have raised 3 great kids and have the same wife I did 33 years ago, so the partial szs have not held me back at all. I strongly encourage you to pay attetion to how you're feeling, keep a journal about it and about what meds you are on (and the dosages), and don't accept a poor quality of life! You are waaaay too young for that! Keep us posted.

It is hard to decide whether I should try a different medicine or not. My n-doc in particular is very wary of any change in medication. It took quite a bit on convincing on my part to get off Lamictal, since I had come to the conclusion that it did next to nothing except preventing me from experiencing a normal human's fluctuation in moods (before I went on to Keppra my Lamictal dose was doubled after a breakthrough, then increased a little more). And it always poses a risk, especially since I do a fair amount of driving.

Since I've been seizure free for nearly 5 years (and I mean that, not a single symptom, not even a twitch), I might request an EEG just in case of the low chance my brain activity may have evened out. I think it's been about 7 years since I last had one, so I think I'm a little overdue.

 

[arnie]

I guess after all that time it might be kind of hard to know if it was the meds or, as you were saying, a normal part of aging, leaving home, etc. The EEG might be a good idea. Although a normal EEG doesn't necessarily mean there are no problems, the doc might want to try to reduce the med dose some. Do you think there is a chance you will ever be able to get off the meds completely? That would be nice, wouldn't it?
Carry on!

 

[chris-s11]

Yes, it certainly would. Not just because I'd finally learn what it's like to be off medication but also because I probably won't be on my parents health insurance much longer!